[Molecular basis of obesity: appetite regulation and energy metabolism control].
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Biomedical subjects
Publications and source records attributed to A Barba Chacón.
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For the nursing profession, the practice of minor surgery means the recovery of an activity which possesses a long historical tradition in our profession and an experience for nurses to provide a specific service in health care. The incorporation of minor surgery as one of the services offered by Primary Outpatient Clinic Care is taking place slowly but surely, especially in light of the advantages it provides. For several years now, some health professionals, nurses and doctors belonging to the Andalucian Health Services, have been actively working on the development and implementation of Minor Surgery Programs inside the Health Clinics of our community. One of our lines of work has been the development of protocols for the treatment of the most habitual lesions by means of minor surgery. Among these are cutaneous cysts whose protocol we present in this article.
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Decubitus ulcers present a real challenge to health care workers. Primary care nurses, in particular, are faced with special considerations when treating a patient in his or her home. For them, it is often necessary to adapt or design treatments to meet the particular circumstances of the patient. Within their Home Health Program, the authors have developed a self care method that is based on educating patients and the family members who will assist them. In this way the families and patients become partners in the planning and application of the proper nursing care that will allow them a greater independence and quality of life.
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BACKGROUND: The elevated incidence of malnutrition in the elderly and its close relation with the prevalence and evolution of determined diseases raises the need for early identification. Despite the existence of numerous indicators, specificity, sensitivity or occasionally both are lacking. METHODS: One hundred fifteen institutionalized elderly of which 19 females and 12 males had signs of malnutrition were studied. A dietetic survey was carried out on all of those studied by means of a 24 hour recollection-interview, during which triceps fold (TF) and muscular area of the arm (MAA) were measured and serum concentrations of prealbumin (PA) protein bound to retinol (PBR), albumin (ALB), trasferrin (TNF) and complement factor 3 (C3) were determined. RESULTS: Not only caloric but also proteic intake were significantly lower in the undernourished (p less than 0.001) as with ALB (p less than 0.001), TNF (p less than 0.001) and C3 (p less than 0.02 in males and p less than 0.05 in females). However, the sensitivity demonstrated by the dietetic survey (77% in males and 73% in females) was higher to that presented by ALB (44% in males and 53% in females), TNF (33% in males and 53% in females) and C3 (0 in both sexes). CONCLUSIONS: The results obtained demonstrate that the dietetic survey is a valid method for detecting not only the risk but also the subclinical presence of malnutrition, in contrast to ALB, TNF and C3 which, to that end, were of less use.
Effects of calorie/protein malnourishment have been studied on plasma concentrations of cholesterol, triglycerides, HDL-C, LDL-C and apolipoproteins A and B, in institutionalized elderly people, 53 males and 62 females, of whom 19 females and 12 males were malnourished. In malnourished patients, total cholesterol and LDL-C were significantly lower both in males and in females, but HDL-C was lower only in females. No significant differences in plasma triglycerides were found between the control and the malnourished groups. Apolipoprotein A showed no significant changes on malnourished males, but did show a significant lowering in malnourished females. On the opposite, apolipoprotein B was lower in males than in females. The lowering in cholesterol in malnourished patients leads us to think that this could be a early predictor of nutritional risk in the elderly.
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The aim of this study is to prove the existence of a major tendency of platelet aggregation in elderly patients compared to medium-aged adults and, also, to detect whether it is affected by the presence of diabetes mellitus. Plasmatic concentrations of B2 thromboxane (TXB2) and antithrombin III (AT III) were determined in 73 elderly patients of both sexes; 56 without metabolic disease known (Group a) and 17 diabetic patients, 7 type I (Group bI) and 10 of type II (Group bII); and 12 healthy adults (control group). Medium plasmatic concentration of TXB2 was significantly higher (p less than 0.001) in Group a (55 +/- 14 ng/ml) compared to the control group (37 +/- 9 ng/ml) and there was no difference between Group bI (53 +/- 19 ng/ml) and bII (57 +/- 15 ng/ml). No variations were noted in ATIII concentration between the adults (27.4 +/- 2.3 mg/dl) and elderly patients (a = 29.6 +/- 4.4, bI = 29 +/- 2.6, bII = 31.2 +/- 5.9 mg/dl). In elderly patients, there appears to be a state of platelet pro-aggregation without influence of any risk factor, such as diabetes. This could explain the thrombogenic tendency of this age group.
A patient suffering Cushing disease is presented in whom the administration of ciproheptadine, bromocriptine and sodium valproate in a single dose did not manage to control the clinical-biologic manifestations of the process. Combined treatment with 1.200 mg/day of sodium valproate and 15 mg/day of bromocriptine induced a complete clinical-biological remission, being arterial pressure the last parameter to normalize. The patient who has always refused to undergo surgery has stayed with this treatment for three years, maintaining remission and without appearance of side effects. On two occasions (after one and a half years and after two and half years) the transitory interruption of treatment induced in a few weeks an increase in plasma cortisol levels which again normalized after treatment was re-established. There were no clinical-biological data, pharmacological tests which permitted the prediction of these therapeutic results and therefore, the therapeutic response obtained is not indicative of any specific etiological subtype of Cushing disease.
The alterations in serum concentration of thyroxine (T4), tri-iodine-thyronine (T3), reverse tri-iodinetiroinine (rT3), thyrotropine (TSH and free thyroxine index (IT4L), are studied in 37 patients diagnosed of sepsis who were divided into two groups according to their evolution: Group A: 22 patients who evolved favourably, and Group B: 15 patients who died, as well as in 14 healthy controls; this was carried out in order to establish, on one hand, its prognostic value, and, on the other, which of these parameters is most useful in the evaluation of thyroid function in these patients. A decrease in serum T3 levels was observed in patients from both groups (p less than 0.001) which was accompanied by an increase in rT3 levels (p less than 0.001) and a decrease in It4L (p less than 0.001); No significant modifications were observed in T4 and TSH. On follow up of 12 patients from group A and 14 from group B, an increase in mean T3 concentration was observed (p less than 0.02) only in the first patient from both groups. The greatest discriminative efficacy of thyroid hormones study with an unfavorable sepsis evolution corresponded to a T3 value below 35 ng/dl.
The changes produced by administering a calcium channel antagonist on the releasing of growth hormone (GH) induced by the growth hormone-releasing factor (GHRF), are studied. The study was performed on 7 healthy males between 25 and 35 years old, fasting and in bed. We measured the release of GH after the intravenous administration of 250 micrograms of GHRF on 2 successive occasions; one baseline and the second after 3 previous continuous days of 240 mg/day of verapamil. There were no statistically significant differences between the basal concentrations of GH before and after the administration of verapamil. However, the response of GH to GHRF, measured as maximum increase (before verapamil: 12.5 +/- 5.3; after verapamil: 9.5 +/- 3.9 ng/ml and total increase (before verapamil: 29.6 +/- 12.4; after verapamil: 21.6 +/- 11.9 ng/ml) was significantly lower after verapamil produces a partial blockade of GH release induced by GHRF.
We studied the role played by an adequate metabolic control on lipids, lipoproteins, apolipoprotein A (apo A), apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B), in 30 type I diabetic patients at different states of the diseases. We did not observe significant differences, comparing the mean values of lipids and lipoproteins, in the group of patients with good metabolic control. Patients, without appropriate diabetic control, showed values significantly higher in triglycerides and VLDL-C and significantly lower in HDL-C compared to the values of the control group. In respect of the apoprotein pattern, we did not observe significant differences between controlled diabetic patients; while non-controlled diabetic patients showed mean values higher of apo B, but no differences between apo A and apo A-I. Our results support the previous evidence published by other authors, confirming the relationship between an adequate diabetic control and the onset of lipoprotein changes, that can play a causal role in arteriosclerosis.
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